Endometriosis and the gift of motherhood
When my first period came at age 13, it involved blood clots and extreme pain. I didn’t know what to expect or what was considered “normal,” but thankfully, my mother did. She recognized that my symptoms were unusual and immediately took me to see my pediatrician. I was first prescribed birth control pills, which seemed to help initially, but when my period remained heavy and painful, I was put on a different birth control pill that enabled me to have my period only four times a year. I thought my situation was normal – albeit uncomfortable and inconvenient. No one ever suggested that painful periods could be anything more than bad luck. I would hear women talk about menstrual cramping and see advertisements for medications to relieve menstrual symptoms … I just figured I had bad periods like so many other adolescent and adult women. I believed that for years. Finding answers to years of pain Then, when I was 22, my cousin Emily was diagnosed with endometriosis. I had never heard of it. I figured it was something extreme because Emily’s symptoms were much more severe than mine. Emily’s mother, my aunt Mary Alice, knew enough about my symptoms that she thought I might have endometriosis as well, even though my symptoms were different than Emily’s. Endometriosis is a chronic condition affecting an estimated 5.5 million women in North America — 30-40% of whom become infertile. It occurs when tissue similar to that which...
With great interest, we read the article “Transcatheter Arterial Embolization for Gastrointestinal Bleeding Associated with Gastric Carcinoma: Prognostic Factors Predicting Successful Hemostasis and Survival” by Sangik Park et al (1). In their study, Park et al constructed a multivariate Cox model to identify predictors of successful transcatheter arterial embolization and 30-day survival after transcatheter arterial embolization.
First of all, we express our deep appreciation for your taking the time to read our article and commenting on it.
Adequately treating pain and nausea following uterine artery embolization (UAE) is a continuing challenge. Superior hypogastric nerve block (SHNB) is a successful adjunct technique for decreasing pain after embolization. This letter discusses safety measures for administration of SHNB during UAE using radial artery access, including avoiding inadvertent intravascular injection, choosing the optimal anesthetic, and treating local anesthetic systemic toxicity.
A 27-year-old competitive runner presented with deep right thigh pain for 1 year. A T2-weighted hyperintense 3-cm lesion was found in the right vastus lateralis muscle on magnetic resonance imaging, indicative of a ganglion cyst (Fig 1). Corresponding ultrasound showed a well-defined, hypoechoic lesion confirming the diagnosis of ganglion cyst. This location is rare for g anglion cyst, and such lesions have been treated only by surgical excision. Ultrasound-guided aspiration and sclerosis with sodium tetradecyl sulfate was performed.
We report our experience with medial cuneiform decompressive exostectomy and superficial tendon debridement in 14 cases of recalcitrant tibilalis anterior insertional pain. We reviewed 13 patients (14 feet; 12 females, 1 male; mean age 67.9 ± 7.5; range 55 to 80 years) in whom conservative treatment had failed who had undergone debridement of the insertional tibialis anterior tendon and decompressive exostectomy of the medial cuneiform.
Plantar heel pain is a common disabling condition in adults. Biomechanical factors are important in the development of plantar heel pain. Quantitative changes in rearfoot alignment in patients with plantar heel pain have not been previously investigated. From April 2016 to March 2017, 100 patients with plantar heel pain and 100 healthy individuals were recruited. The foot posture index was used for the measurement of foot alignment. The generalized joint hypermobility condition was assessed using the Beighton scale.
PMID: 29672384 [PubMed - in process]
PMID: 29672377 [PubMed - in process]
Authors: Santonocito C, Noto A, Crimi C, Sanfilippo F Abstract The use of remifentanil in clinical practice offers several advantages and it is used for a wide range of procedures, ranging from day-surgery anesthesia to more complex procedures. Nonetheless, remifentanil has been consistently linked with development of opioid-induced hyperalgesia (OIH), which is described as a paradoxical increase in sensitivity to painful stimuli that develops after exposure to opioid treatment. The development of OIH may cause several issues, delaying recovery after surgery and preventing timely patient's discharge. Moreover, it c...
This may seem a little basic, but I’m a resident and am curious how most people dose their opioids. I generally don’t give any long acting opioids for cases without significant post op pain. For cases where they’ll need post op analgesia, I usually dose some long acting opioids at the start of GA because I think it lets me use less fentanyl and smoothes out the hemodynamics. So long as it’s a modest dose, I haven’t had anyone yet that fails to breath by the end of the surgery. Do others do... Opioid dosing under GA
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